I have been looking at some of the photos I took in Zambia and realising what a partial view they offer. As I was going through them, I kept thinking “if only I had a shot of that view” or “it didn’t look like that at all” or ‘why didn’t I get that”. That’s the nature of a short visit; you think you’re seeing a lot but there are so many gaps in the view and you have to beware of making judgements based on such a limited experience. Zambia presented me with equal measures of stimuli and confusion so it could be easy to leap to mistaken conclusions.
Much of my time at the beginning was spent in trying to sort out what was happening, attempting to understand what people were saying and not knowing where I was or where I was going. Like any new place, it took a while to orient myself. This was my first experience of working in a developing country and had I not been able to work alongside two experienced trainers, Lesley and Joanna, I would have been completely lost. The people I met were unfailingly courteous and helpful but I struggled to follow conversations and to pick up the keys to what was being said. Although the official language is English, Zambians also use many other languages and often used Nyanga, Bemba or another local language as well. The subtleties of gesture and non-verbal communication in Zambia meant I must often have missed something or, worse, just appeared plain rude.
The teaching sessions were accordingly difficult at first but gradually began to make a comprehensible pattern and it became apparent that the course we delivered really did offer a useful toolkit for the Zambian mental health workers who took part. Now that Zambian ethical approval has been obtained to conduct an evaluation of the work, it will be possible to gather data and information about the impact we are having and to test out the outcomes of the training more rigorously. Health systems in Zambia are very different to those I am used to in Scotland and evaluating what we do is correspondingly more challenging but equally important.
It has been good to find out that the skills and knowledge I had acquired over my years of practice in Scotland were valid and useful in Zambia and could be shared with workers there. I still feel that I have only just begun to understand the differences and similarities in Zambia and in the Zambian health system compared to Scotland, and I have a lot more to learn. It was good to come back to Scotland and find that the Scottish Government is focusing on Zambia as one of its partners for international development work and will announce a new funding initiative in early March 2017. ZTA will hopefully be able to get involved in this new strand of work and to continue its contribution to mental health systems in Zambia.